The present invention relates to a brace for external fixation of bone fractures. More particularly, the present invention relates to an apparatus for external fixation of a fracture of a long bone of a limb which is conveniently applied, allows access to a wound, and is comfortable to wear.
External fixation, or bracing, of fractures of the long bones of the body has become an increasingly common practice. The technique has become increasingly common as a result of the work conducted by Dr. Augusto Sarmiento beginning in about 1963 and published, for instance, at 59 J. Bone Joint Surg. [Am.] 596-601 (1977). The technique has been found especially useful for patients with markedly comminuted fractures, infected nonunion, bone defect or loss, extensive skin or soft tissue wounds in an open fracture, burn patients with fractures, aged patients in whom immobilization is undesirable, and in the case of a limb with concomitant fracture in the forearm or when early mobilization is indicated. Epps, C. H., Jr., Fractures of the Shaft of the Humerus, in Fractures in Adults, C. A. Rockwood, Jr. and D. P. Green, Eds., Philadelphia: J. B. Lippencott, pp. 653-674 (1984).
In spite of the proven utility of this technique, there is room for improvement in the apparatus used as the brace. The braces used for fixation of the humerus provide an example of how such braces can be improved. There are two basic types of braces available for external fixation of fractures of the humerus, the "clam shell" and so-called Sarmiento braces. The first is a hinged, cylindrical shell made of plastic with a soft liner. The Sarmiento brace is a cylindrical shell with a strap or cup over the shoulder to keep the brace from sliding down the arm. Neither allows air circulation and/or wound management and hygiene without removal. Both are problematical if the fracture is near the ends of the humerus. Further, neither is adjustable for patients with fat/muscle structures different from those of the idealized patients for whom these braces are made and supplied. For these, and other reasons, it is an object of the present invention to provide an improved brace for external fixation of long bone fractures.
Further prior art braces are shown in U.S. Pat. No. 4,436,088 and U.S. Pat. No. 4,393,866. The braces disclosed in these two U.S. specifications each consists of a principal elongate member of a substantially "U" cross section which carries straps and a second elongate member, also of substantially "U" cross section, adapted to be nested within the first member in an inverted orientation so that the two elongate members can be used to surround a limb. The two members may be urged together by tightening the straps of the first member around the second member. Each member is provided with a few small apertures therein to help the limb that is carrying the brace to "breathe".